Papers by Stefania Barbieri
Toxicology Letters, 2017
days. Their ecotoxicity and genotoxicity was investigated by means of luminiscent bacteria test (... more days. Their ecotoxicity and genotoxicity was investigated by means of luminiscent bacteria test (Vibrio fischeri), algal growth inhibition test (Desmodesmus subspicatus), Allium cepa assay, and Salmonella typhimurium reverse mutation assay (Ames test). The results of Vibrio test showed EC 50 (30 min) values in the range of 221-440 ml/l, in the Desmodesmus test the EC 50 values lay between 279 and 406 ml/l, with no significant differences in the separate weekdays. The Allium cepa test revealed significant root growth inhibition and increased occurrence of chromosomal aberrations in all samples. Genotoxicity was not confirmed in the plate Ames test, however, the necessary sample sterilization by filtering might have caused a loss of genotoxic activity as certain chemicals may be captured on the filters. Other types of sterilization (e.g. centrifugation) should be investigated for the purpose of testing. The study will continue with optimization of sample preparation (sterilization) and investigation of wastewater samples from other facilities in different seasons.
È nota l'associazione tra infezione da virus del papilloma umano (HPV) e sviluppo di lesioni ... more È nota l'associazione tra infezione da virus del papilloma umano (HPV) e sviluppo di lesioni precancerose e neoplasie cervicali. Con l'inizio dell'attività sessuale le donne entrano in contatto con il virus ma non tutte sviluppano una risposta immunitaria sufficiente ad evitare una futura reinfezione. Una protezione efficace e duratura viene conferita attraverso la vaccinazione. Lo studio ha l'obiettivo di valutare presenza e livelli di anticorpi anti-HPV, sia derivanti dall'infezione naturale che dalla vaccinazione, in un campione di ragazze e giovani donne. Nel periodo ottobre-dicembre 2011, sono stati complessivamente raccolti, dalle eccedenze delle procedure analitiche eseguite presso il Laboratorio Analisi dell'Ospedale S. Anna di Ferrara, 798 campioni di siero anonimi. Il gruppo di controllo è formato da 110 maschi e 151 femmine di età inferiore a 10 anni. La quota restante appartiene a soggetti di sesso femminile: 270 ragazze di 11-18 anni e 267 donne di 19-26 anni. La ricerca anticorpale è stata effettuata con test immunoenzimatico ELISA (DRG) per evidenziare presenza e livelli di IgG dei ceppi 6,11,16,18 espressi in EU/ml. In aggiunta per ogni soggetto è stata allestita una serie di diluizioni per ottenere il titolo anticorpale. L'analisi statistica è stata condotta con StatView® applicando il Chi quadro sulle percentuali di campioni positivi ed il t di Student per il confronto tra livelli e titoli anticorpali (valori trasformati logaritmicamente). Tutti i campioni appartenenti al gruppo di controllo sono risultati negativi. Complessivamente i sieri in cui è stata riscontrata la presenza di anticorpi sono stati 168, di cui solo 22 tra le giovani donne. Oltre la metà (54,1%) delle ragazze è risultata positiva contro una percentuale dell'8,2% nella fascia d'età superiore evidenziando una differenza statisticamente significativa (p<0,0001). La concentrazione di IgG è distribuita in un range variabile da 14,52 a 200,88 nella fascia d'età 11-18 anni e da 14,69 a 130,91 in quella 19-26 anni. Il titolo geometrico medio di 68,85 EU/ml (IC 95% 65,73-71,97 EU/ml) rilevato nelle ragazze è oltre il doppio rispetto a quello evidenziato nelle giovani donne (28,98 EU/ml, IC 95% 18,93-39,03 EU/ml). Il confronto tra le fasce d'età ha evidenziato una differenza significativa (p<0,0001). Alti livelli di titolo anticorpale sono stati riscontrati nelle ragazze, di cui oltre la metà ha valori superiori a 1:500 (34 casi 1:500, 35 casi 1:1000 e ben 42 campioni con titolo maggiore di 1:2000). Nelle giovani donne il più elevato titolo riscontrato è stato 1:1000. La metà dei campioni ha raggiunto solamente un titolo di 1:125 e solo 8 casi fino a 1:250: tra i due gruppi esiste una differenza significativa (p<0,0001). La maggiore frequenza di campioni positivi ed i livelli anticorpali più elevati ha riguardato la fascia 11-18 anni, corrispondente alle coorti di nascita interessate dall'offerta attiva della vaccinazione ed in cui generalmente si verifica il debutto sessuale. Purtroppo l'assenza di indicazioni circa i comportamenti sessuali e la vaccinazione non permette di distinguere se derivino da infezione naturale o immunizzazione, tuttavia il riscontro di un titolo anticorpale positivo ad elevate diluizioni permette di ipotizzare si tratti della risposta alla vaccinazione
Le informazioni sul consumo di albumina in Italia nel 1994 indicavano un valore complessivo di 42... more Le informazioni sul consumo di albumina in Italia nel 1994 indicavano un valore complessivo di 422 Kg/106 abitanti/anno, dato che poneva l'Italia tra i maggiori consumatori di albumina in Europa. L’infusione di albumina viene usata nella gestione dei pazienti con cirrosi epatica avanzata allo scopo di migliorare il volume circolante efficace attraverso un incremento della pressione oncotica. Materiali e metodi: In questo lavoro è stato eseguito un monitoraggio relativo all’uso dell’albumina in un particolare tipologia di pazienti ESLD (end stage liver disease). Nel corso degli anni la strategia aziendale ha portato alla promozione dell’uso corretto dell’albumina, grazie ad una attenta sorveglianza da parte dei clinici e della Direzione Sanitaria che con capillarità ha permesso di cogliere le modalità locali di impiego, con congrui e continui interventi di sorveglianza nell’intero Percorso Diagnostico Terapeutico Assistenziale (PDTA) del paziente cirrotico terminale. Il metodo utilizzato è stato quello dell’indagine conoscitiva relativa al consumo di albumina nel “percorso del paziente cirrotico” ricoverato presso un Ospedale Universitario, in lista di attesa di trapianto di fegato o trattati per ESLD. L’analisi delle diagnosi principali, la tipologia e la durata dei ricoveri, la gestione dei pazienti e il trattamento specifico, ha permesso di costruire un percorso ottimale nel processo diagnostico e terapeutico della patologia e delle complicanze, riducendone i costi
Digestive and Liver Disease, 2019
Veterinaria italiana, Jan 30, 2018
The present case study concerns a case of predation of 4 individuals of captive pink flamingo in ... more The present case study concerns a case of predation of 4 individuals of captive pink flamingo in Emilia Romagna Region, Northeastern Italy. The pink flamingo (Phoenicopterus roseus) is a species included in the Red List of Threatened Species established by the International Union for Conservation of Nature (IUCN) which lists species in danger of extinction. During the Winter of 2013, 4 flamingos (2 in the Comacchio area, and 2 from Argenta and Codigoro oases - Ferrara province) were found dead some of them headless, with their bodies severely bitten. At first, a fox (Vulpes vulpes) was suspected to be the predator responsible for the killing and the birds were taken to the laboratory for further investigations. The investigations included: field observations, study of the predator behaviour, necropsy examinations, assessment of the intercanine distance, and genetic analysis on the predator's traces. The intercanine distance indicated that the predator could not have been a fox. ...
Minerva medicolegale; archivio di antropologia criminale, psichiatria, e medicina legale
Alcool e incidenti stradali: considerazioni epidemiologiche
Minerva medicolegale; archivio di antropologia criminale, psichiatria, e medicina legale
L'incidenza dell'abuso nelle intossicazioni e nei decessi alcool correlati: esperienza de... more L'incidenza dell'abuso nelle intossicazioni e nei decessi alcool correlati: esperienza decennale della città e provincia di Ferrara
Minerva medicolegale; archivio di antropologia criminale, psichiatria, e medicina legale
INTOSSICAZIONI ALCOOL-CORRELATE: ESPERIENZA DI NOVE ANNI NELLA CITTA' E PROVINCIA DI FERRARA
VALUTAZIONE DELL’IDONEITA’ A MANSIONI LAVORATIVE A RISCHIO IN BASE ALLA n.99/cu DEL 30 OTTOBRE 20... more VALUTAZIONE DELL’IDONEITA’ A MANSIONI LAVORATIVE A RISCHIO IN BASE ALLA n.99/cu DEL 30 OTTOBRE 2007 (G.U. 15 Novembre 2007 n.266)
Mission Studies
ABSTRACT Consumo di alcool e incidenti in montagna
Minerva medicolegale; archivio di antropologia criminale, psichiatria, e medicina legale
Detection of ketamine and norketamine in human serum and urine in GC-M
Toxins, 2019
Oleander (Nerium oleander) is an ornamental plant common in tropical and sub-tropical regions tha... more Oleander (Nerium oleander) is an ornamental plant common in tropical and sub-tropical regions that is becoming increasingly widespread, even in temperate regions. Oleander poisoning may occur in animals and humans. The main active components contained in the plant are cardiac glycosides belonging to the class of cardenolides that are toxic to many species, from human to insects. This work describes a case of oleander poisoning that occurred on a small cattle farm and resulted in the fatality of all six resident animals. Furthermore, the investigation of the poisonous agent is described, with particular focus on the characterization of the oleandrin toxin that was recovered from the forage and rumen contents. The innovation of this study is the first description of the detection and quantification of the oleandrin toxin by liquid chromatography-high resolution mass spectrometry (LC-HRMS) in rumen.
Journal of Clinical Anesthesia, 2020
Transplantation Reviews, 2019
Transplantation Proceedings, 2018
Background. Liver transplantation (LT) is an established treatment for patients with end-stage li... more Background. Liver transplantation (LT) is an established treatment for patients with end-stage liver disease. The significant advances in surgical technique, immunosuppression therapy, and anesthesiological management have dramatically improved short-and longterm outcomes. The aim of this study is to correlate specific surgical and anesthesiological variables with causes of early death in LT recipients. Methods. A retrospective observational analysis of adult patients who underwent LT in the period 2012 to 2016 and died within 90 days following LT was conducted. Exclusion criteria were intraoperative death, split liver, and domino transplant. Death was considered a dependent variable and classified into 3 different groups: death by sepsis, vascular events not related to the graft, and primary non-function. Donor and recipient variables were considered and analyzed using Fisher's exact test. Results. Statistically significative associations (P value < .05) were found between renal function support, retransplantation, and the number of fresh frozen plasma units transfused in one group and early death due to sepsis in the other. Conclusions. This study identified some risk factors associated with the specific cause of early death in liver transplantation. The clinical implications of these findings are the ability to stratify patients at high risk of early death by planning more intensive and accurate management for them. A DVANCES in the perioperative management of liver transplantation (LT) patients have improved outcomes, reflected in decreased short-and long-term morbidity and mortality. However, the tendency to transplant very sick recipients explains why the morbidity rate is unchanged in the early post-transplant period and often results in patient death. Different studies have been conducted to define factors influencing early mortality but none have defined the correlation between these factors and cause of death. The aim of this study is to define variables leading to a known cause of early death in the posttransplant period. MATERIALS AND METHODS A retrospective analysis of a prospective database of LT performed between January 2012 and January 2016 at the Hepatobiliary Surgery and Liver Transplantation Unit of Padua University Hospital was conducted. Selection criteria for the study included adult liver transplant recipients who died within 3 months due to the procedure. Cause of death was categorized into 3 groups: sepsis, vascular events not related to the graft, and primary non-function (PNF). Sepsis was defined using the criteria of the Third International Consensus Task Force [1]: vascular events were described as vascular complications not related with the graft and PNF was defined as aspartate aminotransferase level 3000 associated with at least one of the following: international normalized ratio 2.5, acidosis corresponding to arterial pH 7.30 or venous pH 7.25, and/or serum lactate levels 4 mM. For patients who needed a retransplantation (Re-LT), variables were collected from the last transplant. Exclusion criteria were intraoperative death, domino transplant, and patients who received a split graft.
Journal of Clinical Anesthesia, 2016
Background: Postoperative residual neuromuscular blockade (RNMB) is a common complication in the ... more Background: Postoperative residual neuromuscular blockade (RNMB) is a common complication in the postanesthesia care unit (PACU), but also one of the most controversial issues. Many studies and trials demonstrated that some methods and techniques can reduce the incidence and the extent of the phenomenon. Study Objective: To determine the incidence of RNMB in the PACU at standardized times after extubation with the implementation of a protocol of careful neuromuscular blockade management. Design: Randomized, single-blinded controlled clinical trial. Setting: Operating room and PACU. Patients: A total of 120 patients of either sex with American Society of Anesthesiologists grades 1, 2, and 3, aged 18 to 80 years were scheduled to undergo elective abdominal surgical procedures lasting for at least 60 minutes. Interventions: Patients were randomized to receive either cisatracurium (n = 60) or rocuronium (n = 60) at the time of intubation and during surgery. Every patient received quantitative neuromuscular monitoring during general anesthesia. On completion of surgery, patients were given neostigmine 0.05 mg kg −1. Patients were extubated at a train-of-four (TOF) ratio ≥0.9. Measurements: TOF measurements were performed 15, 30, and 60 minutes after extubation. Tolerability of neuromuscular monitoring was evaluated with a scale from 1 to 10 (with 1 meaning no discomfort at all and 10 meaning maximal discomfort or pain). ☆ Disclosures: No funding was provided for this work.
Transplantation Reviews, 2017
Compromised liver function, as a consequence of acute liver insufficiency or severe chronic liver... more Compromised liver function, as a consequence of acute liver insufficiency or severe chronic liver disease may be associated with various neurological syndromes, which involve both central and peripheral nervous system. Acute and severe hyperammoniemia inducing cellular metabolic alterations, prolonged state of-neuroinflammation‖, activation of brain microglia, accumulation of manganese and ammonia, and systemic inflammation are the main causative factors of brain damage in liver failure. The most widely recognized neurological complications of serious hepatocellular failure include hepatic encephalopathy, diffuse cerebral edema, Wilson disease, hepatic myelopathy, acquired hepatocerebral degeneration, cirrhosis-related Parkinsonism and osmotic demyelination syndrome. Neurological disorders affecting liver transplant candidates while in the waiting list may not only significantly influence preoperative morbidity and even mortality, but also represent important predictive factors for post-transplant neurological manifestations. Careful pre-transplant neurological evaluation is essential to define severity and distribution of the neurological impairment, to identify the abnormalities still responsive to current treatment, and to potentially predict the inherent post-operative prognosis. The preferred specific indices of neurological pretransplant assessment may vary among centers, however, even with the aid of the current biochemical, neurophysiological, neuropsychological and neuroimaging diagnostic tools, the correct diagnosis and differential diagnosis of various syndromes may be difficult. In this article the relevant pathophysiological and clinical aspects of the most frequent brain and peripheral nervous system diseases affecting liver transplant candidates with acute or advanced chronic liver failure are briefly reported. The practical diagnostic findings useful for the preoperative assessment and treatment, as well as the expected neurological evolution after liver transplantation are also evaluated.
Asian Journal of Surgery, 2007
Combined hepatocellular cholangiocarcinoma (cHCC-CC) is an uncommon histological variant of prima... more Combined hepatocellular cholangiocarcinoma (cHCC-CC) is an uncommon histological variant of primary liver cancer. This combined type of tumour lesion follows an aggressive clinical course with an unfavourable prognosis. Although the role of orthotopic liver transplantation in the management for hepatocellular carcinoma is well defined, to date, there has been no report on its treatment value for cHCC-CC. We report our experience of orthotopic liver transplantation in three patients with cHCC-CC. One patient succumbed to distant metastases 16.5 months after liver transplantation whereas the other two patients continued to survive 35 and 25 months after transplantation, respectively.
BACKGROUND Helmet use is now viewed as an essential safety measure in almost all sports involving... more BACKGROUND Helmet use is now viewed as an essential safety measure in almost all sports involving a high risk of impact and head trauma, from horseback riding to mountain biking, rock climbing and winter sports such as skiing and snowboarding. For young skiers and snowboarders under the age of 14, the use of certified helmets is compulsory in Italian law, although no defined regulations exist for recreational sledding OBJECTIVE To review past and current regulations covering winter sports, to explore potential legal discrepancies in appraising factors related to helmet use in recreational activities by children under the age of 14, and to identify hazards connected with various types of sledding accidents METHODS Descriptive data of the cases of 16-year-old or younger adolescents injured while sledding without helmets were gathered from injury reports collected by ski patrols, pre-hospital emergency services and emergency departments, and compared with 53 cases of adolescents and ch...
JMIR Pediatrics and Parenting, 2018
Background: The links between the internet and teenager behavior are difficult situations to cont... more Background: The links between the internet and teenager behavior are difficult situations to control and may lead to the development of new and excessive methods of drinking alcohol during alcoholic games. Findings indicate that reported cases are very useful sources for better understanding of alcoholic games, yielding successful measures promoting health among adolescents. Admittance of adolescents to hospital emergency departments (EDs) after consumption of excessive amounts of alcohol has become the norm in developed countries. The harmful effects of acute alcohol abuse are reported in this paper. Objective: The aim of this work was to investigate the close connections between new drinking behaviors among adolescents and study the increase in new alcoholic games, together with the challenges that cause acute alcohol intoxication, the influence of the internet and social networks, and their consequences for public health services. Methods: Data came from prehospital and intrahospital admissions attributable to alcohol consumption. From 2013 to 2015, 3742 patients were admitted to EDs due to acute alcohol intoxication: 830 of them were aged 15 to 30 years, and 225 were adolescents and young adults between 15 and 20 years who had been playing alcoholic games. Retrospectively, diagnostic data associated with extrahospital anamneses were selected by one of the hospital management information systems, Qlik. As a result of our previous experience, questionnaires and face-to-face interviews were performed at a later stage, when a clinical audit for intoxicated adolescent patients was described, with the overall goal of establishing a potential methodological workflow and adding important information to research carried out so far. Results: Between 2013 and 2015, 830 young patients aged 15 to 30 years were admitted to EDs for acute alcohol intoxication. About 20% (166/830) of the sample confirmed that they had drunk more than 5 alcoholic units within 2 hours twice during the past 30 days as a result of binge drinking. Referring to new alcoholic games, 41% of the sample stated that they knew what neknomination is and also that at least one of their friends had accepted this challenge, describing symptoms such as vomiting, headache, altered behavior, increased talkativeness, and sociability. The median value of the weighted average cost of the
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Papers by Stefania Barbieri